A Life Destroyed
=My ETS nightmare Part I= By songboy1234 How could this happen? How could I have been so stupid? I consider myself to be a rather intelligent person. How could I have been tricked into allowing my own body to be mutilated like this? I have been transformed from a normal, happy, energetic human into a weak, angry, bitter freak of nature. My body can’t control its temperature very well. My hands and face are burning and dry all the time. I can never sweat from my upper body no matter how hot it is or how hard I try to exercise, meanwhile my lower body will sweat rivers from the slightest physical exertion. I can’t stand touching dry textures, such as paper. I have lost an entire part of my emotional spectrum, and my heart will not respond to fear or thrills. I’m tired all the time, and I can’t work out like I used to. When I’m not covered in a cloud of suicidal depression, I’m filled with hateful anger. My dream career as a composer and musician, once successful, has been destroyed. Is this real, or is it all just some horrible nightmare? Hey, Nobody Else Is Sweating Everyone has a weakness, I suppose. And my weakness, my vulnerability turned out to be my embarrassment over sweating. Yep, sweating. For some reason, as I entered my 30’s, it became easy for me to sweat from the face when I would get into a nervous situation. Maybe something in my body chemistry changed, maybe it was just that I was dealing with more stress and nervousness than before, I don’t know. But there were plenty of times, say, at a business meeting, or a music industry function, when I would start sweating over becoming slightly nervous. I would look around, notice that nobody else was sweating, and wonder, “Why me?” Perhaps my worst sweating episode ever was when I went to go see a music supervisor at Disney. The music business is very competitive, so when a last-minute call came in looking for a song for a new movie, I burned a CD of a few of my songs and drove down to Burbank for a meeting. I guess all of the perspiration planets were in alignment that day. First off, I wasn’t feeling well and had a slight fever and a sore throat. It was a hot day in the high 90’s. It was about a 5 minute walk to get from the parking lot, through the Disney compound, and up a flight of stairs to the guy’s office. Still, I wasn’t sweating. I got to see him without waiting, unusual. He put my CD on and began listening. I must have looked a little hot, because he offered me a juice. I shouldn’t have. I knew better. But my throat was so parched, I was so thirsty. . .I said yes and the secretary fetched me a bottle of designer OJ. It was one of those days where the bottle itself was sweating. I opened it and poured the delicious liquid down the hatch. Heaven. More. I couldn’t stop. I killed the whole bottle just as Mr. Music Supervisor skipped ahead on my CD, missing the best part. Boink! The first drop of sweat trickled down my temple. I nonchalantly mopped it with my sleeve. Listening to my own songs with other people singing is one thing, but listening to my own voice in a pressure situation is rough. Plop! Another drop across my forehead. I blew a puff of air upwards trying to cool down. Useless. Bam, Bam, Bam! Before the last chorus, sweat was running down my face, dripping off my chin, and making dark water spots all over the front of my shirt. Mr. Disney guy peered up at me. I saw the look on his face. He was horrified. Even if he might have liked one of my songs, he sure wasn’t going to now! I told him I wasn’t feeling great (the truth), and got out of there. Needless to say, none of my songs made it in that particular movie. On the way home from that meeting, by some incredible coincidence, I heard a pitch on talk radio about “a simple outpatient procedure to cure hyperhidrosis”. The ad had mentioned sweaty palms, and I wondered if there was anything to be done about my sweaty face. Months passed by, and there were a few more embarrassing incidents, though not as bad as the Disney sweat-fest. Thoughts of a surgical cure remained in my mind. Finally, in September of 2002, I decided find out about this “simple outpatient procedure”. I did some searching on the internet and found several surgeons who treated hyperhidrosis, including Dr. Richard Smith down in Orange County. I made an appointment for a consultation, and on September 19, 2002, I met the man who would change my life forever. My Consultation I kind of liked Dr. Smith when I met him. He was smart and confident. He seemed concerned as I told him of my sweating problem. He asked about my medical history and if I had tried anything else to deal with my sweating. I hadn’t. He briefly told me about topical creams and iontopheresis, and why those treatments were no good. He said that based on what I told him, that I was suffering from “hyperhidrosis”, and said that the best way to treat hyperhidrosis was with a surgery called “Endoscopic Transthoracic Sympathectomy” or ETS for short. Dr. Smith explained that there were two types of sweating – “physiologic sweating” and “non-physiologic sweating”. The first type, the physiologic sweating, was important for the body to cool down, but the second type, the non-physiologic sweating, was unnecessary. He told me the non-physiologic sweating was controlled by a little nerve inside the body called the “sympathetic nervous system”, which was like a little thermostat, and that my thermostat was set too high. He said there were a series of these ganglia inside my chest, and that they were referred to as T1, T2, T3, T4 etc. He said that if I wanted to stop the nervous sweating from my face, he would have to remove T2 and T3, and if I wanted to stop any nervous sweating from my armpits, he would also remove T4. Dr. Smith assured me that ETS was tried and true, because doctors had been doing sympathectomies for decades using some old “open surgery” method, and now, with modern microinvasive endoscopes, the procedure was completely safe, and could be done through two tiny incisions less than 1/4 inch long. He also bragged about how he had developed his own unique method of ETS that was better than anyone else’s method, because he used a harmonic scalpel, which generated no heat. He said I could have the procedure on a Friday, and be back at work on Monday, and that he even had one patient who played tennis the very day after surgery! I had brought a notebook with me to the consultation to take notes, and to remind myself of a few questions to ask Dr. Smith. I asked him about side effects, and he said that there were only two possible side effects of ETS. One was called Horner’s Syndrome, which he said was “a little bit of a droopy eyelid”. He told me I needn’t worry about that because Horner’s is caused by accidental damage to the T1 nerve ganglia, and he had never had a case of Horner’s in over 300 surgeries. The other possible side effect was called “compensatory sweating”, which was just a little extra sweating from the abdomen or lower back. He said that, unlike other methods of ETS, his method carried a very low risk of compensatory sweating. He said only 20% of his patients get any compensatory sweating at all, and only 1 or 2% get it significantly. And, in any case, this extra sweating had disappeared and gone away within one year in all of his patients. I finished noting all this, and then glanced at another of my questions. I asked, “What about normal sweating, from heat or exercise?” “ETS has NO effect on normal sweating” assured Dr. Smith. These were his exact words, and I wrote them in my notebook as he spoke. He went on to tell me a little story. He said that people need to sweat to regulate body temperature. He said that if a guy was in a hot desert and couldn’t sweat, he could get fever, heatstroke, and eventually die. “Sympathectomy has no effect on normal, physiologic sweating”, he repeated. All of this sounded great to me. Dr. Smith was going to snip out the defective nerve that caused my excess nervous facial sweating, and the only possible side effect was a slight chance of a little extra sweating from my belly and back for the first year. I shook Dr. Smith’s hand, and went to go book the surgery with his secretary. I scheduled a T2, T3 ETS for about 2 weeks later. I still wanted to do some more research, and I figured that gave me plenty of time, just in case I changed my mind. In the next few days, I visited 6 or 8 other websites that discussed ETS surgery. All of them seemed to be saying the same thing, that ETS was safe, and effective, and that the only possible side effects were Horner’s syndrome and compensatory sweating. This seemed like a consensus. I was excited. Finally I was going to be rid of my stupid sweating problem. Now I could go to industry functions and meetings with confidence and charm. My life was already good, and it was going to get even better! A few days before surgery, Dr. Smith called me and confirmed that I was coming in for surgery the following Friday. While he had me on the phone, he asked why I had only requested the T2 and T3 surgery, and not included the T4. “You don’t really want sweaty armpits, do you?” he prodded. “I guess not”, I replied. “Well, then, you should also have me take out the T4”. I agreed. Who needs sweaty armpits either? On Friday, October 11, 2002 my wife drove me down to A Major Medical Center. She walked me in to the admitting area, and gave me a hug and a kiss goodbye, which sent a chill up my spine. Little did I know it would be the final time I ever experienced that wonderful sensation. The last thing I remember before surgery was the anesthesiologist asking me if I knew what was being done to me. I answered “Yes”, but in reality I had no earthly clue. The Recovery Room As I came to in the recovery room, my first thought was “Oh my God, what’s wrong with me?” Something inside me felt terribly wrong, indescribably strange. I was shaking. I’d been under anesthesia before, and never come out shaking. I tried to convince myself I’d feel fine as the drugs began to wear off. The voices of the nurses were soothing as I was wheeled into a hospital room. Everything went fine, I was told. My Chest!? I can’t feel my chest! My entire chest was numb. I asked the nurse why that was, and they didn’t know, they said I should ask Dr. Smith when he came to check on me in a little while. The worst thoughts were racing through my mind, thinking that a wrong nerve was cut accidentally. Strangely, as scared as I was right then, my heart wasn’t pounding. Must be the drugs, I thought. I lay in my bed worrying for over 2 hours, when finally Dr. Smith arrived. The first thing he did was feel my right hand and proclaim, “Nice and warm and dry!”. I couldn’t help wondering if he had me confused with one of his palm-sweating patients. I asked him about the numbness in my chest, and he explained that he had used a “nerve-blocking agent” which was standard, and that my chest would be numb for about a month. What?! I was shocked. Nerve-blocking agent? A month? He hadn’t told me about any of this. I thought I’d be back to normal in a couple of days. I was still a little groggy and I didn’t say anything. At least he hadn’t cut the wrong nerve, that was a relief. Before he left, Dr. Smith assured me that everything went just fine, and that I could go home as soon as I felt like standing up. Around then my wife called to say she would be there in a couple of hours. I’m a huge Anaheim Angels fan, and they had made the playoffs in 2002. I turned the playoff game on and watched from the hospital bed. It was a thrilling game against the Minnesota Twins. Funny thing, I didn’t feel any excitement as I watched this nail-biter. Must be the drugs, I thought again. Right as the game ended in a 2-1 victory for the Angels, my wife showed up and took me out of there. My Heart! What’s Wrong With My Heart? I spent the next few weeks trying to adjust to the pain. Even though my chest was numb from whatever the hell nerve-blocker Dr. Smith used, the ribs under my arms felt like they had been bashed with a baseball bat. And my nipples! They were shriveled up and pointy like they get in the cold, except they were so sore I couldn’t touch them. What was all this? And my hands. My hands felt really hot and dry, throbbing all the time. I was taking the Vicodin pain pills that had been prescribed, which took the edge off. So, I called Dr. Smith to find out what was wrong, and what he told me was probably the most shocking, astounding thing I’ve ever heard. In a very matter-of-fact way, Dr. Smith informed me that the throbbing sensation in my hands was due to the fact that my blood vessels could no longer constrict. I was speechless. He tells me this NOW? WHAT?!? He also told me that I might have to apply hand lotion to keep my hands from feeling too dry. I’d already been doing that, and it wasn’t working very well. Little did I know then that the pain medication was dulling the sensation in my hands, and once I went off the medication, my hands would constantly feel like they were burning. How on earth could Dr. Smith not have warned me about this stuff? I would never, ever have had ETS if I’d have known it would paralyze my blood vessels, or make my hands burn. No way. And nothing could have prepared me for what happened next. One night, about 3 weeks after surgery, I was lying in bed, waiting for the Vicodin to kick in and dozing off to sleep. KABOOM! There was a loud explosion outside that rattled my window. I felt a jolt of adrenaline surge through my body. But then, my heart didn’t start pounding. I hopped out of bed to look out my window, in time to see a minor league firework and carload of teens speeding away. I put my hand to my chest, and could barely feel my heart at all. We all know the feeling. Something scares you, first you feel the jolt of adrenaline, then a second later your heart starts pounding, taking a minute or two to go back to normal. But not this time. Very, very odd. Could this be from the pain pills too? I went downstairs and did a few push-ups to get my heart going. My ribs still hurt like fire, but I went for it anyway. I still couldn’t feel my heart pounding like I would expect. I went up and down the stairs 4 or 5 times. I was getting really winded, more so than I should have, and still I couldn’t even feel my heart beating in my chest. Panic. 2 more laps up and down the stairs. More push-ups. I felt the pulse in my neck and my heart rate was somewhat faster than it would be at rest, but something was clearly wrong here. I couldn’t make my heart pound no matter what. And something else was wrong too. I was sweating like crazy on my belly and lower back, but not at all from my head. Could Dr. Smith have accidentally cut the wrong nerves, the ones that control normal sweating? My wife and daughter were asleep. I stood there, alone in the dark, tears welling up, as the sad discovery began to sink in. Something was profoundly wrong with me. I stayed up all night, crying and pacing. My mind was panicking, but my heart couldn’t have cared less. Edited by: songboy1234 at: 8/22/05 10:52 pm source